PEDIATRIC RADIOLOGY, cilt.33, sa.10, ss.693-696, 2003 (SCI-Expanded)
Background. Laparoscopic surgery is a good alternative to the open technique for treating hernias in female paediatric patients. The laparoscopically inverted and sutured hernia sac forms a nodule, the long-term fate of which has not been previously studied radiologically. Objective: To describe the early and delayed US changes after laparoscopic inversion and suturing of paediatric female inguinal hernias. Materials and methods: Twenty girls (age 1.5 months to 12 years; median 4.6 years) who underwent laparoscopic inguinal hernia repair were prospectively evaluated with US the day before and the day after the procedure. Delayed scans were obtained at 1, 6 and 12 months. Results: The laparoscopic procedure involved inversion and suturing of the hernia sac, which resulted in a nodule that plugged the internal inguinal ring and resembled a rosebud laparoscopically. US detected the 'rosebud' in all cases on the first postoperative day. Initially appearing as a rounded or ovoid mass with a slightly hypoechoic texture, the 'rosebud' became progressively smaller, more hypoechoic and more lobulated On follow-up. It disappeared in all but two cases at 6 months and in all cases at I year. There was no US evidence of recurrence. Conclusions: The 'rosebud' formed by this laparoscopic procedure displays typical US features and temporal changes.